Adjectival descriptions of personality disorders: a convergent validity study of the MCMI-III.

The responses to a 469-item list of adjectives (consensually validated by national experts as representing key descriptors for each personality disorder) from 202 male substance abusers in outpatient treatment were correlated with their responses to the MCMI-III, a frequently used test for the assessment of personality disorders. Results suggested good convergent validity for the interpersonal descriptive domain for the MCMI-III scales. The Histrionic scale had extremely high convergent validity.

Psychological needs associated with MMPI-2 scales in a nonclinical sample.

The psychological needs derived from the Adjective Check List (ACL; Gough & Heilbrun, 1983b) that are associated with MMPI-2 scales were studied among 198 nonclinical participants. Both the Depression (D) and Psychasthenia (Pt) scales were negatively correlated with needs for achievement and dominance and positively correlated with needs for abasement and succorance (dependence). The Schizophrenia (Sc) scale was negatively associated with need for affiliation and positively associated with need for abasement. The Social Introversion (Si) scale was associated negatively with needs for achievement, dominance, affiliation, heterosexuality, exhibition, and autonomy and associated positively with needs for succorance, abasement, and deference, reflecting good construct validity for Scale Si. MMPI-2 Masculinity-Femininity (Mf) did not correlate with the ACL Masculinity and Femininity scales, suggesting poor concurrent validity for Mf.

Methadone maintenance. Does dose determine differences in outcome?

We conducted a naturalistic study to determine if higher methadone doses were more effective than lower doses in the outcome variables of illicit drug use, treatment retention, missed medication days, and ratings of patient progress by assigned counselor among 265 patients in a Department of Veterans Affairs Methadone Maintenance Treatment Program. Results indicated no significant differences on any outcome variable by methadone dose. However, we found a significant effect by assigned therapist. Some therapists achieved better outcome results on these same variables compared to other assigned therapists independent of dose level. We conclude that, while methadone maintenance dose is an important variable, researchers need to pay more attention to the interpersonal aspects of methadone maintenance treatment.

Testimony based on the Millon Clinical Multiaxial Inventory: review, commentary, and guidelines.

Test results from the MCMI have been ruled admissible in court for a variety of clinical and forensic issues. This article addresses MCMI issues such as the test's applicability and admissibility of test results in forensic evaluations, test administration, test scoring, malingering and deception, prediction and diagnosis of behavior, reliability, validity, operating characteristics and diagnostic efficiency statistics, and use of computer-assisted interpretation of test results for forensic presentation. Recommendations are suggested for dealing with each of these issues in a forensic context.

Psychological assessment (MMPI-2) of male African-American substance-abusing patients with and without histories of childhood physical abuse.

Twenty-nine drug addicted patients in a VA substance abuse program with a history of childhood physical abuse were compared to 29 drug addicted patients without a history of childhood abuse, using the MMPI-2 as a measure of personality traits and functioning. Drug addicted patients with an abuse history showed psychological maladjustment on almost all measures and at greater levels of intensity and severity than the nonabused group. We conclude that drug addicted patients who have been abused represent a unique subset of the drug addicted population and may require targeted psychological treatment for residual problems associated with childhood abuse. This may then also improve the efficacy of substance abuse treatment as well.

Factor structure of the MCMI-III.

The factor structure of the Millon Clinical Multiaxial Inventory (Millon, 1994; MCMI-III) was assessed among 444 African American inpatient substance abusers and constitutes the first factor analysis of the MCMI-III. We found 3 main factors: General Maladjustment, Paranoid Behavior/Thinking With Detached Emotionality, and Antisocial Acting Out. These factors were essentially similar to previous findings of factor studies with the MCMI and MCMI-II across diverse populations. This factor invariance should lend credibility to the revised test and spur additional research into its psychometric properties.

Stability of the MCMI-III in a substance-abusing inpatient sample.

The stability of the MCMI-III personality disorder and clinical syndrome scales was assessed in a substance-abusing inpatient sample of 35 African-American men over an average test-retest interval of 6 mo. Estimates were higher for the personality pattern scales than for the clinical syndrome scales. The Dependent personality pattern scale (.83) and the Narcissistic personality pattern scale (.80) were reliable after about six months, whereas Drug Abuse, Somatoform, and Major Depression showed lower stability. As in previous research using the MCMI-I/II, estimates were lower than those reported in the test manual.

Assessing PTSD with the Millon Clinical Multiaxial Inventory-III.

We studied the utility of the Millon Clinical Multiaxial Inventory-III (MCMI-III) in assessing substance-abusing (n = 228), combat-related PTSD patients (n = 32). The MCMI-III produced a code type (16A) that was quite different from MCMI-I and MCMI-II code types (8A2) among similar populations. The PTSD Scale (R) successfully differentiated between a PTSD and non-PTSD substance-abusing group using mean Base Rate scores, was the best predictor of PTSD in a multiple regression equation, and the scale's sensitivity and specificity in detecting and/or ruling out the disorder was above that provided by chance alone and higher than the values reported in the test manual for that scale. The MCMI-III may be used as a broad band screening instrument for PTSD, at least among patients with combat-related stress.

Sensitivity of MCMI-III Scales T (drugs) and B (alcohol) in detecting substance abuse.

The sensitivity and specificity of MCMI-III Scales T (drug dependence) and B (alcohol dependence) were evaluated with patients (N = 164) in an inpatient substance user treatment program. The sensitivity levels of these two scales improved significantly compared to previous research using the MCMI I and MCMI II Scales T and B, which had not achieved sensitivity values above .50. However, specificity for detecting alcoholism among drug misusers was lower compared to MCMI I and II studies. Results suggest improved diagnostic sensitivity with the MCMI-III in diagnosing substance misuse, but lowered efficiency in ruling out the disorder.

MCMI-III-derived typological analysis of cocaine and heroin addicts.

A sample of 441 African American men who were either inpatient heroin or cocaine addicts, or both; were assessed with the MCMI-III. The modal codetype showed primary elevations on the Antisocial Personality Disorder Scale (6A), consistent with previous research using the MCMI-I and MCMI-II with substance abusers. The data were subjected to 3 independent clustering procedures that resulted in general consistency among procedures. The solutions were validated on a randomly selected half of the sample. Three subtypes were variants of the antisocial parent codetype, whereas another subtype was characterized by a Within Normal Limits profile suggesting no personality disorder. These 4 subtypes were also associated with different external correlates with significant clinical import. The results suggest that findings from previous research with substance-abusing patients, using the MCMI-I and MCMI-II, should be applicable to the MCMI-III as well.

Correspondence of MMPI and MMPI-2 with chemically dependent patients.

One hundred (39 women and 61 men) hospitalized substance abusers were administered the MMPI and MMPI-2. The correspondence of T-Scores, Codetypes, and MAC/MAC-R scores were analyzed. Results showed that the MMPI-2 produced profiles that were consistent with previous research on the MMPI with substance abusers. However, the relationship between MMPI and MMPI-2 T-scores appeared complex and varied across individual scales for both men and women. Codetype congruence was 38% for one, two, and three-point code-types. Well-defined codetypes accounted for 30% of the profiles. MAC/ MAC-R raw scores were different for men but not for women. Codetypes established for the MMPI may not be fully transferable to the MMPI-2 in a substance abusing population.

Psychological screening of impotence with Finney's MMPI-derived Impotence Scale.

Three groups of patients in treatment were assessed for impotence, using MMPI-derived Impotence Scale. Group I were 46 patients who had been screened and scheduled for a penile prosthesis when the impotence resulted from known organic causes (biogenic). Group II were 198 patients in a sexual dysfunction clinic, for whom biogenic causes had been ruled out (psychogenic). Group III were 51 substance abusers in drug rehabilitation. While scores on the Impotence Scale did not distinguish between the biogenic and psychogenic groups, the scores were almost three times higher than average scores among subjects in the standardization sample. MMPI-derived Impotence Scale scores were similarly elevated among the substance abusers. Results suggest that the Impotence Scale may serve as a useful screening tool to alert clinicians to the possibility of erectile dysfunction for which further clinical evaluation would be required.

16 PF profiles and typologies for patients seen in marital therapy.

The purpose of this study was to examine and describe the personality characteristics of 145 patients seen in outpatient marital therapy in private practice. Cluster analysis of the entire sample resulted in five separate typologies which were statistically significant and clinically meaningful and which suggested different goals for counseling. Patients seeking marital therapy were significantly more tense, anxious, worrisome, suspicious, bold, and shrewd than the normal persons in the 16 PF standardization sample.

Contributions to psychohistory: XXIII. Hemingway "analyzed".

This paper is a review of major published works from psychoanalysts, psychiatrists, psychologists, academic scholars, and experts who have presented an "analysis" of the personality of Ernest Hemingway. Points of agreement and contrasting points of contention are discussed.

Clinical diagnoses and MCMI codetypes.

From a comprehensive literature review of all papers published on the Millon Clinical Multiaxial Inventory (I/II) from 1980-1993, MCMI test codetypes associated with various personality and clinical disorders were derived from the empirical literature. They are presented in an Appendix for clinical and research interests.

Comparison of MCMI-II and 16PF validity scales.

We administered the Millon Clinical Multiaxial Inventory-II (MCMI-II; Millon, 1987) and the Sixteen Personality Factors Inventory (16PF; Cattell, Eber, & Tatsuoka, 1970) to 131 outpatients in marital therapy and tested the correlation between the validity scales of the two instruments. The results indicated that MCMI-II Disclosure and Debasement scales were positively correlated with the 16PF Fake-Bad scale and negatively correlated with the 16PF Fake-Good scale. The MCMI-II Desirability scale was significantly correlated with the 16PF Fake-Good scale.

MCMI-II profiles and typologies for patients seen in marital therapy.

The Millon Clinical Multiaxial Inventory-II profiles of 145 patients in marital therapy, seen in a private-practice outpatient setting, were subjected to a hierarchical cluster analysis. Four distinct clusters were found (MCMI-II Codetypes 58B4, 8A6B8B5, 3217, and 37). Each of these clusters suggested different therapeutic goals. There were some scale differences by gender, with women tending to score higher on the Dependent Scale. We argue that private-practice settings generate a wealth of data which can be taken from such files and used to address empirical questions.